Article Data

  • Views 114
  • Dowloads 16

Original Research

Open Access

Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of flexible bronchoscopy and urology stone retrieval basket in emergency setting

  • Paola Ciriaco1
  • Angelo Carretta1,2
  • Piergiorgio Muriana1
  • Giampiero Negri1,2

1Department of Thoracic Surgery, San Raffaele Scientific Institute, Milan, Italy

2School of Medicine, Vita-salute San Raffaele University, Milan, Italy

DOI: 10.22514/sv.2021.014 Vol.17,Issue 2,March 2021 pp.93-97

Published: 08 March 2021

*Corresponding Author(s): Paola Ciriaco E-mail:


Objective: Tracheobronchial aspiration of foreign body in children is an emergency that can lead to major complications. In the last years flexible bronchoscopy has gained popularity for foreign bodies retrieval in the pediatric population, yet the small size of the pediatric airway and of the flexible bronchoscope channel limit the availability of instruments during the procedure. Aim of this paper is to describe our experience in treating foreign bodies tracheobronchial aspiration in children aged 2 years or less by means of flexible bronchoscope and an urology stone retrieval basket.

Methods: A review of endoscopic foreign bodies removal by means of flexible bronchoscopy and urology stone retrieval basket has been carried out in children ≤ 2 years that presented at the Emergency Room of our hospital from 2005 to 2019. In the paper, we analyze characteristics of patients, timing of bronchoscopy, instruments and operative management.

Results: There were 25 patients with a mean age of 20 ± 3.8 months. Organic material was the most frequent observed foreign body. Association of main bronchus and distal bronchi was the preferred site of the foreign body in 19 patients and the right side of the bronchial tree was involved in 17 cases. Complications occurred in one case. Mean operation time was 37 ± 20 minutes.

Conclusions: The use of flexible bronchoscope can be helpful in handling endoscopic removal of tracheobronchial foreign bodies in toddlers. The use of the urology stone retrieval basket resulted very effective in all shapes of foreign bodies and/or when the object was located in the distal bronchi.


Foreign body; Aspiration; Bronchoscopy; Children

Cite and Share

Paola Ciriaco,Angelo Carretta,Piergiorgio Muriana,Giampiero Negri. Tracheobronchial foreign body aspiration in children aged ≤ 2 years: the use of flexible bronchoscopy and urology stone retrieval basket in emergency setting. Signa Vitae. 2021. 17(2);93-97.


[1] Varshney R, Zawawi F, Shapiro A, Lacroix Y. Use of an endoscopic urology basket to remove bronchial foreign body in the pediatric population. International Journal of Pediatric Otorhinolaryngology. 2014; 78: 687-689.

[2] Mnejja M, Chakroun A, Bougacha L, Smaoui L, Ben Salah M, Chakroun A, et al. Bronchoscopy for foreign body inhalation in the pediatric population: lessons learned from 223 cases. Archives de Pédiatrie. 2012; 19: 670-674.

[3] Oguzkaya F, Akcali Y, Kahraman C, Bilgin M, Sahin. Tracheobronchial foreign body aspiration in childhood: a 10-year experience. European Journal of Cardio-Thoracic Surgery. 1988; 14: 388-392.

[4] Gang W, Zhengxia P, Hongbo L, Yonggang L, Jiangtao D, Shengde W, et al. Diagnosis and treatment of tracheobronchial foreign bodies in 1024 children. Journal of Pediatric Surgery. 2012; 47: 2004-2010.

[5] Salih AM, Alfaki M, Alam-Elhuda DM. Airway foreign bodies: a critical review for a common pediatric emergency. World Journal of Emergency Medicine. 2016; 7: 5-12.

[6] Rodrigues AJ, Scussiatto EA, Jacomelli M, Scordamaglio PR, Gregório MG, Palomino ALM, et al. Bronchoscopic techniques for removal of foreign bodies in children’s airways. Pediatric Pulmonology. 2012; 47: 59- 62.

[7] Divarci E, Toker B, Dokumcu Z, Musayev A, Ozcan C, Erdener A. The multivariate analysis of indications of rigid bronchoscopy in suspected foreign body aspiration. International Journal of Pediatric Otorhinolaryngology. 2017; 100: 232-237.

[8] Baram A, Sherzad H, Saeed S, Kakamad FH, Hamawandi AMH. Tracheobronchial foreign bodies in children: the role of emergency rigid bronchoscopy. Global Pediatric Health. 2017; 4: 2333794X17743663.

[9] Swanson KL, Prakash UBS, Midthun DE, Edell ES, Utz JP, McDougall JC, et al. Flexible bronchoscopic management of airway foreign bodies in children. Chest. 2002; 121: 1695-1700.

[10] Mansour B, Elias N. Foreign body aspiration in children with focus on the role of flexible bronchoscopy: a 5 year experience. The Israel Medical Association Journal. 2015; 17: 599-603.

[11] Suzen A, Karakus SC, Erturk N. The role of flexible bronchoscopy accomplished through a laryngeal mask airway in the treatment of tracheobronchial foreign bodies in children. International Journal of Pediatric Otorhinolaryngology. 2019; 117: 194-197.

[12] Ramírez-Figueroa JL, Gochicoa-Rangel LG, Ramírez-San Juan DH, Vargas MH. Foreign body removal by flexible fiberoptic bronchoscopy in infants and children. Pediatric Pulmonology. 2005; 40: 392-397.

[13] Hata A, Nakajima T, Ohashi K, Inage T, Tanaka K, Sakairi Y, et al. Mini grasping basket forceps for endobronchial foreign body removal in pediatric patients. Pediatrics International. 2017; 59: 1200-1204.

[14] Elsharkawy H, Abd-Elsayed AA, Karroum R. Management challenges in the passing-through technique using a fogarty catheter to remove an endobronchial foreign body from an infant. Ochsner Journal. 2015; 15: 110- 113.

[15] Ciriaco P, Negri G. Tracheobronchial foreign body in small children: the combination of flexible bronchoscopy and the urology stone retrieval basket. Archivos de Bronconeumología. 2019; 55: 174-175.

[16] Tang FL, Chen MZ, Du ZL, Zou CC, Zhao YZ. Fibrobronchoscopic treatment of foreign body aspiration in children: an experience of 5 years in Hangzhou City, China. Journal of Pediatric Surgery. 2006; 41: e1-e5.

[17] Boufersaoui A, Smati L, Benhalla KN, Boukari R, Smail S, Anik K, et al. Foreign body aspiration in children: experience from 2624 patients. International Journal of Pediatric Otorhinolaryngology. 2013; 77: 1683-1688.

[18] Thatte NM, Guglani L, Turner DR, Forbes TJ, Gowda ST. Retrieval of endobronchial foreign bodies in children: involving the cardiac catheterization lab. Pediatrics. 2014; 134: e865-e869.

[19] Lax EA, Kiran SH, Lee MW. Bronchoscopic retrieval of a bullet using a Dormia basket: a case report. Journal of Medical Case Reports. 2014; 8: 358.

[20] Kambartel K, Filipiak A, Hüschen H, Krbek T, Voshaar T. Foreign body removal with Roth-Net®. Pneumologie. 2013; 67: 520-521.

[21] Fang Y, Hsieh M, Chung F, Huang Y, Chen G, Lin S, et al. Flexible bronchoscopy with multiple modalities for foreign body removal in adults. PLoS ONE. 2015; 10: e0118993.

[22] Zhao Y, Zhang Y, Zhang L, Xie X, Liu D, Yu G. Treatment strategy of hilar and intraglandular stones in wharton’s duct: a 12‐year experience. The Laryngoscope. 2020; 130: 2360-2365.

[23] Thakur A, Buchmiller T, Atkinson J. Bronchial perforation after closed-tube endotracheal suction. Journal of Pediatric Surgery. 2000; 35: 1353-1355.

[24] Samra S, Schroeder JW, Valika T, Billings KR. Tracheotomy for difficult airway foreign bodies in children. Otolaryngology-Head and Neck Surgery. 2018; 158: 1148-1149.

[25] Liu J, Xiao K, Lv X. Anesthesia and ventilation for removal of airway foreign bodies in 35 infants. International Journal of Clinical and Experimental Medicine. 2014; 7: 5852-5856.

[26] Soodan A, Pawar D, Subramanium R. Anesthesia for removal of inhaled foreign bodies in children. Paediatric Anaesthesia. 2004; 14: 947-952.

[27] Ding G, Wu B, Vinturache A, Cai C, Lu M, Gu H. Tracheobronchial foreign body aspiration in children. Medicine. 2020; 99: e20480.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time